Pseudomembranous (Clostridium difficile) colitis: toxic megacolon

Case contributed by Dr Chris O'Donnell

Presentation

On oral antibiotics. Unwell with abominal pain, diarrhoea and bleeding. Not getting better.

Patient Data

Age: 40
Gender: Female

Gross edema of the left hemicolonic wall with marked proximal colonic distension.  Note surrounding inflammation with signs of low serum albumin including marked subcutaneous edema on CT. There are multiple enlarged mesenteric lymph nodes. Patient is unwell with poor nutrition and colonic dilatation = toxic megacolon. Clostridium difficile cultured in feces.

CT

Scan performed 1 week prior to the above examination

One week prior had less marked edema of left hemicolonic wall, no proximal colonic dilatation, and no signs of poor nutrition including subcutaneous edema.

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Case information

rID: 17548
Published: 25th Apr 2012
Last edited: 16th Oct 2015
Inclusion in quiz mode: Included

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